By David M. Greenwald
Executive Editor
Davis, CA – The city council on Tuesday will receive a report from the subcommittee on a potential Crisis Now effort and will be asked to agree to a partnership with Yolo County, contributing about $1.17 million over a three-year period.
Back in April, the city council, as part of the “reimagining public safety” discussion, created a subcommittee of Vice Mayor Lucas Frerichs and Councilmember Josh Chapman to work with city and Yolo County staff to determine “if and how Davis could partner with the County on the Crisis Now model.”
This is part of a series of nine recommendations that was originally presented from subcommittee to council in December 2020.
In May, Karen Larsen, Director of Yolo County Health and Human Services presented the Crisis Now model to the council.
A similar program has been implemented in Maricopa County, Arizona. A video shows that the program saves the equivalent of 37 full time police officers, reduces the wait time in emergency rooms by around a collective 45 years by diverting people in mental health crises away from standard ER beds, and they estimate it produces an overall cost saving of $37 million systemwide.
The Crisis Now model moves away from alternatives such as the co-responder model that is often favored by law enforcement, which would have an embedded social worker arrive with an armed police officer.
Larsen explained that the “crisis model would not have clinicians going out with law enforcement, clinicians would go out with someone with lived experience to respond to mental health crises.”
The proposal explained by Larsen included an access/crisis call center, a 24/7 mobile crisis response team, and crisis stabilization programs, including a receiving center. The county at that time was working to determine total costs and the funding gap that would need to be filled to make the system viable.
The county has been in conversation with cities in Yolo, including Davis, on a shared model.
“The County has officially asked for the cities to invest ARPA [American Rescue Plan Act] funding in the shared amount of one million dollars per year for three years,” the subcommittee writes. “They have further proposed that this amount be shared based on population size with Davis funding 39%, Woodland funding 32%, and West Sacramento funding 29%. This would result in an annual $390,000 cost for Davis, or a total of $1,170,000.”
The subcommittee at this point is agreeable to this, writing, “While Davis can agree to this population-based split as a starting point, we would recommend revisiting the breakdown after the program has been implemented to determine whether adjustments should be made, whether to the population split or the overall methodology.”
As proposed this would have three key components: a 24/7 Crisis Call Center, Co-responder team, and Receiving Center which includes a Sobering Center.
“The County already fully funds a 24/7 Crisis Call Center. They are hoping to improve the technology for this service and potentially partner in a regional model but anticipate continuing to fund this portion of the model fully,” the subcommittee reports.
The county also partners to share the cost of co-responders. But the Receiving Center would be entirely new.
These services are projected to cost upwards of $12 million per year. The county would continue funding 100 percent of the Crisis Call Center.
The subcommittee notes: “The Crisis Receiving Center is the piece of this model that potentially benefits the cities the most, and most directly addresses concerns outlined in the reimagining public safety conversation. This component is approximately $5 million annually. The proposed funding would have the County pay for 60% of the costs, with the cities covering 20%, private insurance paying 15%, and health systems covering the remaining 5%.”
In addition, “The Short-term Beds are the piece of this model where the health systems stand to benefit the most. This piece of the model is estimated to cost approximately $6 million.”
With that said, “The Crisis Now Model is projected to save millions of dollars above the shared investment.”
Some of these will be quantifiable. The county, for instance, “expects a measurable reduction in inpatient psychiatric hospitalizations and a reduction in short term jail bed days associated with having a sobering center.”
In addition, “the health systems can track the reduction in emergency department utilization for substance use and mental health crises, anticipated to be somewhere between 50-55% lower than current numbers.”
On the other hand, cost avoidance might be harder to track.
Assuming the Davis City Council supports this program and expenditures, the next step will be seeing if Woodland and West Sacramento agree to participate as well. Discussions are expected to take place over the next six to eight weeks.
And clinicians must go out with people who use woke buzz-phrases. Has the lived experience needed been defined? What if they haven’t actually lived it? Do they have to wait for someone with lived-experience or do you call the cops? What about un-lived experience, or dead experience from one’s phase as a zombie?
Just as important, if this is a county-shared program, does that mean it will be dispatched from Woodland, or will “lived experience” people be ready-to-go all over the county 24/7?
What happens the first time someone is dispatched to a scene that turns violent? Do we go back the co-responder model? I don’t mean to P on the effort as I support it, but did this never happen in Eugene or elsewhere? This is a sincere question.
Cost of program to Davis + Cost of Police < Current Cost of Police + Inflation
Simple.
I kind of believe “Lived experience” was a typo from the original presentation, but not sure if I have time to check. But I also think it is more colloquialism than some sort of “woke phraseology” although the origin is from Husserl and quite old, the origins are from phenomenology philosophy.
I am sorry to read Alan Miller’s sarcastic and cynical thoughts about having individuals with “lived experience” be part of the Crisis Now project. Far from being “woke” language, including individuals with the lived experience of mental illness is very important. In suicide prevention, including those who have attempted suicide and survived in interventions has proven helpful in preventing more attempts. Here in Yolo county, peer-driven mental health wellness (as opposed to illness) groups have been functioning for a number of years with support from HHS and NAMI Yolo. For a number of years, if you went to the HHS offices in the Bauer Building there was a coffee stand – Cool Beans – that was managed and run by mental health consumers. People with “lived experience” are members of the Yolo Mental Health Advisory Board – as they should be.
Language is important. How we speak of those who suffer from and with serious mental illness makes a difference. For decades these individuals have been stigmatized and ostracized, in part, via language. For years mental health professionals referred to them as if they were their illnesses – schizophrenics, borderlines, or too often “frequent flyers.” Sure, you can say this was just shorthand, but objectification of people leads down a dark road. Changes in the language are efforts to humanize and allow the people who suffer from mental illness to be full participants in the process of health.
Language norms are like all other norms, they evolve and change as the culture does. It’s time more people woke up to this.
RC, I understand this is your area and therefore you are sensitive to it. I was only referring to the term which I find humorishly overused as well as used politically. Seriously — an experience is, by definition, lived.
In case you feel I am insensitive to mental health issues, my sister died of complications from an unexpected, seemingly out-of-the-blue mid-life total nervous breakdown which was never effectively treated (and maybe could not have been), and my brother died of complications from addiction that I’m sure was rooted in mental illness as well. I have many friends in the mental health and substance abuse fields and have more than a handful who have or are dealing with these issues. I’ve donated to NAMI and similar organizations.
I am almost always something resembling sarcastic and cynical. I prefer to think of it as adoption of a droll persona of feigned irreverence, often with a cryptic purpose. In this case, unintentionally, allowing you to make a point.
I find the evolution of language to range from beneficial/sensitive to ridiculous/humorless/scary. For instance, not referring to the hills east of Guinda as “N*gger Heaven” on USGS maps is a good thing and sensitive. Having generations criticized as insensitive for using terms that were accepted for 95% of their life because they didn’t read last week’s ‘woke manual’ is itself insensitive.
Criticism of this phrase that I consider a woke dog whistle in some contexts will not change. I agree that those who have experienced situations are often best suited to help persons dealing with those same traumas. Criticism of aspects of modern use of a paired word set need not connect dots that imply insensitivity to related issues.
Cool beans.